AccountId: 011433970860
ContactId: 54a6ad7e-613b-4c84-ae21-f209851d5204
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251119 ms
Total Talk Time (AGENT): 94189 ms
Total Talk Time (CUSTOMER): 80302 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/54a6ad7e-613b-4c84-ae21-f209851d5204_20250516T20:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I just need to see if a patient has eligible benefits and then see if an MRI needs prior or a CT needs prior authorization.
[AGENT][NEUTRAL] OK, I can help you with eligibility and uh prior off. Do you have the, uh, could I get your name and a good callback number? Sorry.
[CUSTOMER][NEUTRAL] Yeah, it's [PII], and then my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And then can I get the policy number for that patient?
[CUSTOMER][NEUTRAL] Yeah, it's D as in Delta 43729287.
[AGENT][NEUTRAL] OK, thank you. Um, that policy number actually is with 90 degree benefits, but we do also have policies for members of them. So, do you have the last name of the patient or the social, and I can see if we have something.
[CUSTOMER][NEUTRAL] Let's see, last name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And first name is [PII] if you need that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I, uh.
[CUSTOMER][NEUTRAL] I'm like there's a medical ID which is what I gave you plus a policy number. I don't know if that's what you would need.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Uh, yeah, the policy number is 2414102.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, perfect. OK, let me give you the benefits under this policy, but then I can transfer you to 90 Degree um to see if there's any additional benefits.
[CUSTOMER][NEUTRAL] That I can
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well it's the first time I've called you guys, so I'm like we'll just call the number on the back and see where we get.
[AGENT][POSITIVE] I, I totally understand.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, and did you have his date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, got him effective [PII]. Policy is currently active.
[AGENT][NEUTRAL] Let me get that pulled up. This is a limited hospital indemnity policy, so it has very limited benefits. So let me see if they've got a diagnostic benefit.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And not a guarantee of payment basic outline of that policy. Uh, for diagnostic testing, they have a maximum payable of $250.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then let me make sure there's nothing else under those. I think there is.
[AGENT][NEUTRAL] Yeah, it doesn't look like there's anything else for CAT scan. Um, but like I said, I can get you over to 90 benefits. There may be an additional benefit under that policy, and you'll provide them with that, um, the one that started with the D.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Hey, get out please.
[CUSTOMER][NEGATIVE] [PII], get out. No, no.
[CUSTOMER][NEGATIVE] You're gonna fall off, get down.
[CUSTOMER][NEUTRAL] Get out.
[CUSTOMER][NEUTRAL] Thank you for calling IMA a 90 Degree benefits company, the administrator for benefits.